Licensure by endorsement is how a nurse who already holds a license in one state obtains one in another without sitting the licensing examination again. It is the route every nurse takes when moving to a state outside the Nurse Licensure Compact, and it is the single largest piece of friction in the American nursing labor market.
The alternative route, licensure by examination, is for new graduates and for nurses who have never held a United States license. Endorsement rests on the examination the nurse already passed. See the NCLEX.
When endorsement is unavoidable
Eleven of the fifty-one states and the District of Columbia stay outside the compact: Alaska, California, the District of Columbia, Hawaii, Illinois, Massachusetts, Michigan, Minnesota, Nevada, New York and Oregon. Working in any of them requires a license issued by that state, whatever else a nurse holds. Massachusetts has passed compact legislation without switching it on, which changes nothing for a nurse today. Individual state entries are under nursing by state.
Endorsement is also required for a nurse whose primary state of residence is outside the compact, however many compact states they work in. A nurse living in California cannot hold a multistate license at all, so every state they work in has to license them separately.
Advanced practice nurses endorse everywhere. The compact covers registered nurses and practical nurses only, so a nurse practitioner needs a license in every state where they see patients regardless of compact membership. See levels of nursing.
What boards ask for
The requirements are similar in outline and differ in every detail. Most boards want:
- Verification that the original license is current and unencumbered, usually pulled electronically through Nursys rather than mailed by the issuing board.
- Proof of graduation from an approved nursing program, sometimes as a sealed transcript sent directly by the school.
- A state and federal fingerprint based criminal background check.
- Disclosure of any disciplinary action, criminal history, or participation in an alternative to discipline program, anywhere, ever.
- A fee, commonly between $100 and $350.
A handful of states add requirements that catch people out. Some require continuing education on specified subjects before the first license is issued, such as child abuse recognition, human trafficking, implicit bias, or state law and rules. Some require a separate jurisprudence examination on the state's own practice act.
Internationally educated nurses face a longer version of the same process. Several boards will not accept their credentials without a full course by course evaluation and an English proficiency test, even when the nurse already holds a United States license issued by another state.
How long it takes
Processing runs from a few days to several months, and the variation is not proportional to the size of the state. The rate limiting step is usually the background check rather than the board's own review, and it is entirely outside the applicant's control.
Many boards issue a temporary permit that allows practice while the full application is pending, typically valid for 60 to 180 days and often conditional on the fingerprint results having cleared. Some issue none at all, which means a nurse who has accepted a job cannot start until the license appears.
For a nurse moving house this is an inconvenience. For a travel nurse it is a business problem, because an unpaid gap between contracts while a board processes an application is a real cost, and it is the reason compact states are easier to staff than non-compact ones. See nurse staffing agencies.
Endorsement is not reciprocity
The two words get used interchangeably and mean different things. Reciprocity implies that two states have agreed to recognize each other's licenses. Endorsement means the receiving state has decided, on its own terms, that the applicant's existing license and education satisfy its requirements. There is no agreement, no obligation, and no automatic acceptance.
A state can and does refuse. Grounds include a nursing program the board does not recognize, gaps in practice hours beyond the state's limit, disciplinary history, or a criminal record the board judges disqualifying. A refusal in one state can then complicate applications elsewhere, because the question about prior denials is on every form.
Related
- Nurse Licensure Compact
- The NCLEX
- Internationally educated nurses
- Nurse practice acts and boards of nursing
- Nursing by state
Sources
- Nurse Licensure Compact. National Council of State Boards of Nursing, member states and implementation status. Accessed September 8, 2026.
- Nursys license verification. National Council of State Boards of Nursing. Accessed September 8, 2026.
- California Board of Registered Nursing, licensure by endorsement. Accessed September 8, 2026.
- New York State Education Department, Office of the Professions, registered professional nursing. Accessed September 8, 2026.